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2017 Dual Options

Dual options provide your employees the chance to choose a plan that best fits their lifestyles and budgets.

Benefits Gold 1000-4 Silver 2000-5
Deductible $1,000 $2,000
Coinsurance 80% 70%
Out-of-Pocket $4,500 $6,800
Primary Care Physician Office Visit $30 copay $45 copay
Specialist Office Visit N/A N/A
Prescription Drugs $10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 for specialty
$15 copay for generics
$50 copay for preferred brand-name
$80 copay for non-preferred brand-name
$160 for specialty
Deductible Type Fulfillment Fulfillment

Benefits Silver 2000-5 Bronze 3500
Deductible $2,000 $3,500
Coinsurance 70% 50%
Out-of-Pocket Costs $6,800 $7,150
Primary Care Physician Office Visit $45 copay N/A
Specialist Office Visit N/A N/A
Prescription Drugs $15 copay for generics
$50 copay for preferred brand-name
$80 copay for non-preferred brand-name
$160 for specialty
N/A
Deductible Type Fulfillment Embedded

Benefits Platinum 500-1 Gold 1500-3
Deductible $500 $1,500
Coinsurance 80% 80%
Out-of-Pocket Costs $1,250 $3,500
Primary Care Physician Office Visit $20 copay $30 copay
Specialist Office Visit $40 copay $50 copay
Prescription Drugs $10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
$10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
Deductible Type Fulfillment Fulfillment

Benefits Platinum 500-1 Silver 2000-5
Deductible $500 $2,000
Coinsurance 80% 70%
Out-of-Pocket Costs $1,250 $6,800
Primary Care Physician Office Visit $20 copay $45 copay
Specialist Office Visit $40 copay N/A
Prescription Drugs $10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
$15 copay for generics
$50 copay for preferred brand-name
$80 copay for non-preferred brand-name
$160 for specialty
Deductible Type Fulfillment Fulfillment

*Copayments apply only to in-network providers.

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